International Migration, Integration and Social Cohesion online publications
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Unmasking imaging biomarkers with deep learning:Applications in acute ischemic stroke
Get PDFStroke is one of the leading causes of death and disability worldwide. An ischemic stroke is caused by a thrombus that blocks a cerebral artery and cuts off blood flow to parts of the brain. If blood flow is not restored quickly, the brain tissue in the affected area starts to get damaged. When stroke patients arrive at the hospital, they typically undergo Computed Tomography (CT) scans of the brain. These scans contain important information which can help guide treatment decisions. This thesis develops machine learning methods to automatically extract imaging biomarkers from CT scans. In this thesis, we develop methods to automatically detect and segment thrombi that block blood vessels in the brain. From these segmentations, we build a fully automated pipeline that can measure features of the thrombus, such as its size, density, and structure, and study how these features are linked to treatment success and recovery. We also create deep learning models that can identify the brain tissue affected in the acute phase of stroke, providing estimates of the infarct core and the surrounding hypoperfused region directly from CT scans. Finally, we design a model to predict which areas of the brain are likely to become irreversibly damaged over time. Together, these tools aim to facilitate the integration of these biomarkers into clinical practice, potentially improving care for stroke patients
Promoting self-regulated learning during the covid-mandated remote learning period: Insights from interviews with primary school teachers
Get PDFThe Covid-19 pandemic challenged teachers to foster self-regulated learning (SRL) in remote education contexts where direct guidance was limited. This study explored how Dutch primary school teachers adapted their SRL support under these conditions. Semi-structured interviews with 10 teachers revealed major challenges, including monitoring student engagement, supporting emotional well-being, and differentiating instruction. Teachers relied mainly on indirect strategies to promote SRL, while direct instruction remained rare. Scaffolding practices often intensified rather than faded, and partnerships with parents became more prominent. Findings underscore the need for better tools and training to support SRL development in flexible and disrupted educational environments
Mobilizing and Balancing Differences:Care Relocation as the Work of Transnational Acting
No full textThis article explores the organizational aspects of care relocation of German seniors to care homes for older adults in the Czech border regions. It examines the role of care entrepreneurs as transnational actors linking diverse contexts in order to create sustainable business projects. It conceptualizes their endeavours as the work of transnational acting grounded in geographic arbitrage, whereby socioeconomic disparities are not merely exploited but strategically mobilized and balanced. The article argues that care relocation arrangements are shaped through the entrepreneurial navigation of inter- and intra-national inequalities. In doing so, it contributes to the literature on care relocation and geographic arbitrage by analysing how care entrepreneurs construct transnational arrangements that are both profitable and organizationally sustainable over time. Ultimately, it demonstrates how global and regional care flows are not only sustained within structures of inequality but actively configured and reconfigured through entrepreneurial practice
Improving outcomes in minimally invasive pancreatoduodenectomy
No full textThis thesis investigates various aspects of minimally invasive pancreatoduodenectomy (MIPD), focusing on its implementation, clinical outcomes, and comparative effectiveness within the Netherlands and across Europe. It highlights the ongoing shift from laparoscopic pancreatoduodenectomy (LPD) to robotic-assisted pancreatoduodenectomy (RPD), supported by data from both national and international registries. The European registry for Minimally Invasive Pancreatic Surgery (E-MIPS) and the randomized controlled DIPLOMA-2 trial form the backbone of this work. The DIPLOMA-2 trial, a multicenter randomized controlled study, demonstrates that MIPD is non-inferior to open pancreatoduodenectomy (OPD) in terms of postoperative complication rates and provides superior outcomes in time to functional recovery.Further analyses confirm that MIPD is both feasible and safe across a broad range of patient populations, including elderly patients, with comparable mortality outcomes to those following OPD. However, inter-institutional variation in outcomes remains. Additionally, the thesis addresses postoperative risk stratification by evaluating fistula risk scores specific to RPD, aiming to enhance perioperative planning and optimize patient selection.Collectively, the findings of this thesis support the safe and evidence-based expansion of MIPD. They underscore the importance of ongoing evaluation through randomized controlled trials and high-quality clinical registries to ensure standardized, safe, and effective surgical practice
Societal Consequences of Data-Driven Advertising
No full textAdvancements in machine learning and artificial intelligence have revolutionized the advertising industry, leading to the rise of computational advertising. This approach relies on the extensive collection and processing of consumer data to deliver individualized and targeted ads. While this data-driven strategy enhances the relevance of advertisements for consumers, it also fosters dataveillance, namely continuous and pervasive surveillance by among others advertisers. In this chapter, we explore the societal and individual implications of dataveillance in the context of computational advertising. We examine how data collection and processing for advertising affects consumer behavior, emotions, and cognition, often leading to negative surveillance responses. Additionally, we address the potential for exploitation and the creation of new disparities as advertisers leverage data to target vulnerabilities. The discussion reflects on the broader impact of computational advertising, highlighting both its potential for persuasion and its ethical considerations in the digital age
Enhancing Position Verification in Multi-Node Quantum Networks
No full textQuantum position verification (QPV) is emerging as a promising application for quantum networks, leveraging spatial and quantum information to verify locations. However, current discussions on QPV protocols are largely confined to perfect experimental setups and one-dimensional scenarios. To address this gap, we extend the QPVBB84f protocol to two dimensions. First, we define the requirements for the 2D QPV task and assess its performance under real-world constraints, which potentially expose the system to external attacks. To strengthen the protocol against these vulnerabilities, we study the 'danger zones', defining a region in spacetime within which attackers can manipulate these real-world constraints to convince verifiers. We then develop two algorithms to implement this theory: the Verifiable Vertices Selection algorithm, which identifies nodes that can validate their locations with designated verifiers, and the Malicious Prover Location Identification algorithm, which determines the 'danger zone' around the prover. Finally, we present a case study to demonstrate the conceptual implementation of the protocol. Our findings advance the development of secure and practical QPV protocols while highlighting the potential of quantum networks in the noisy intermediate-scale quantum (NISQ) era.</p
On light and life:Physics of chloroplast motion and bioluminescence
No full textThis thesis, "On Light and Life – Physical principles of chloroplast motion and bioluminescence", investigates the physics of adaptive responses in biological systems in relation to light. Focusing on the absorption of light in photosynthetic organisms - such as the aquatic plant Elodea densa - we reveal that intracellular rearrangements via chloroplast motion not only alters leaf optics for enhanced light sensitivity or photo-avoidance but also exhibits glass-like collective states under dim light. Through theoretical modeling and disk-packing simulations, we show that plant cell geometry is optimized for chloroplast arrangement, enabling dynamic transitions between absorptive and light-avoidant states.The study is extended to the marine dinoflagellate Pyrocystis lunula, which adapts to light through contraction of a reticulated chloroplast network. This motion, facilitated by a structure reminiscent of metamaterials, acts as a temporal low-pass filter to environmental light changes, selectively responding to persistent stimuli. Despite evolutionary differences, both organisms employ chloroplast mobility for light adaptation, revealing a convergent physical strategy. Shifting the focus to the generation of light, we study and analyze mechanically induced bioluminescence in P. Lunula by refining biophysical models of mechanosensation and light production and applying those to complex situations like wave-impact scenarios. Together, these studies uncover the interplay of intracellular organization, geometry, and dynamics in adaptation and survival.This interdisciplinary work contributes novel insights to biological physics, particularly in active matter, organelle dynamics, and bio-inspired materials, and establishes chloroplast motion and bioluminescence as central topics to investigate how mechanics and interactions with light are coupled in biological systems
Innovations in transfusion practices:Indications, products, and monitoring
Get PDFBlood transfusion practices have come a long way since the introduction of blood banks, which revolutionized medicine by enabling widespread use of whole blood and plasma. In the decades that followed, the focus gradually shifted toward transfusing specific blood components, such as red cell concentrates (RCCs) and platelet concentrates (PCs). Continuous improvements in safety and quality have firmly established transfusion as a life-saving intervention across diverse clinical settings, from the operating room to intensive care. Despite these advances, transfusion medicine often still follows a ‘one-size-fits-all’ approach, overlooking the specific functional needs of different patient populations and transfusion product characteristics. Looking ahead, additional challenges also emerge, including the upcoming ban on di(2-ethylhexyl) phthalate (DEHP) in RCC storage bags, which necessitates the evaluation of alternative options, as well as the ongoing pursuit of non-invasive measurement techniques to enhance patient safety. This thesis presents a series of studies on Innovations in Transfusion Practices, with a central focus on Indications, Products, and Monitoring. A central theme in this thesis is the evaluation of storage durations and the use of biotinylated blood products. The findings support a more personalized approach for PCs, while also demonstrating acceptable outcomes for a new non-DEHP blood bag system for RCCs and highlighting the potential of innovative medical devices for non-invasive hemoglobin measurement.</p
Advanced clinical applications of the Crohn's disease exclusion diet:Unraveling mechanisms, identifying biomarkers and optimizing personalized therapy
Get PDFCrohn’s disease (CD) is a chronic inflammatory bowel disease characterized by relapsing and remitting inflammation of the gastrointestinal tract. While its pathogenesis is multifactorial, involving genetic, immune, microbial, and environmental factors, diet has emerged as a key modifiable contributor. Exclusive enteral nutrition (EEN) is the established first-line therapy for induction of remission in children, yet its restrictive nature limits long-term feasibility. To address this, the Crohn’s Disease Exclusion Diet (CDED) was developed to replicate the benefits of EEN while offering a more palatable and sustainable approach.This thesis is divided into two parts. Part I evaluates the clinical efficacy of CDED in both children and adults through randomized controlled trials. Findings demonstrate that CDED, with or without partial enteral nutrition (PEN), achieves high rates of clinical remission and inflammatory marker reduction, with superior tolerability compared to EEN. Notably, CDED was more effective in maintaining remission at week 12 and showed promising results in adult patients, including mucosal healing in a subset.Part II investigates mechanisms underlying dietary therapy, focusing on the gut microbiome, intestinal permeability, and tryptophan metabolism. Sustained remission was associated with reproducible microbial shifts toward a health-associated profile, improvements in barrier function, and alterations in tryptophan-derived metabolites. Ratios of kynurenine- and serotonin-pathway metabolites emerged as potential biomarkers of treatment response.Together, these findings establish CDED as an evidence-based dietary therapy for CD, highlight its role in sustained remission, and provide translational insights that may guide the development of predictive biomarkers and personalized nutrition strategies in IBD
Advancing anal cancer prevention:Screening strategies and biomarkers for risk stratification
Get PDFThe incidence of anal cancer is on the rise. It is preceded by precancerous lesions (HSIL), making screening possible. Treating HSIL reduces the risk of progression to anal cancer by half. In the Netherlands, screening is offered to groups at an increased risk, like men living with HIV, but current methods are complex, burdensome for patients, and limited by capacity shortages. Furthermore, most HSIL do not progress to cancer leading to overtreatment. This thesis addresses these challenges and aims to guide improvements in anal cancer screening implementation.In Part 1, we evaluated existing anal swab tests (cytology and HPV testing) as initial screening tools and explored multiple algorithms using these tests. Although these tests are suitable for screening, significant improvements are necessary. We also surveyed expert opinions to establish performance criteria for future tests.In Part 2, we investigated methylation markers as a novel approach to enhance anal cancer screening. We showed that they could complement current screening tests, as well as determine cancer risk in anal HSIL, reducing unnecessary treatments. A reproducible methylation test was developed and is being validated in a prospective cohort study.In Part 3, we explored the local immune system of the anal mucosa. We found that patients whose lesions progressed to cancer had more immunosuppressive macrophage profiles.In conclusion, this thesis proposes improvements to anal cancer screening by refining current tools, developing methylation markers, and exploring immune mechanisms of progression. These findings may support more effective, personalized, and resource-efficient prevention strategies